Dressing Without Tears: Sensory-Sensitive Strategies That Work

If your child has tactile (touch) sensitivity, getting them dressed can mean more than a chore.  It can mean tears.  Tags in shirts, “scratchy” jeans, and all that pulling of clothing over their face!  I know families that scheme for months to find clothes that their child will wear to a wedding or buy clothes online because trying on clothing in a store is a nightmare.

The low-hanging fruit:  soft tees and sweatpants/shorts are the most tolerated clothing for kids with sensitivity.  Even these have some caveats.  Clothing that is too loose creates movement while worn, and long cotton sleeves are a good example of irritants for sensitive kids.  Get a good fit and forget about buying things large for growth.  Comfort and compliance now is absolutely key.

Pressure garments and compression underwear:  I have never been a fan of Theratogs.  They are expensive and awkward for most kids.  When they work, they are amazing, but there are lower-tech and lower-priced possibilities.  UnderArmor underwear fits smoothly  and creates a bit of comforting pressure.  Even the lycra sunsuits that kids wear to the beach can be worn under clothing in cooler conditions.  Children who are not toilet-trained are the hardest, since you need to pop off pressure garments to change them.  This could be a great reason to begin pre-training and make your potty training plan.  Take a look at Waiting for Toilet Training Readiness? Create It Instead! for some ideas.

Don’t forget that all sensory responses have a behavioral component.  I am not saying that there isn’t a neurological reason for a child’s discomfort.  Sensory sensitivity is real.  The behavioral piece is that responses can be diminished or increased by experience.  All experiences.  Children with mild to moderate sensitivity can react less when the fear and the novelty of wearing clothes is diminished.  How is that done?  Depends on the child, but short periods of wear that happen frequently and are not forced but are rewarded can transform a child.  Having control over which button-down shirt he wears for 3 minutes, or which video he gets to watch that is only available while wearing “the shirt”, can really make a difference.  So much of tactile sensitivity is anticipatory fear and feeling trapped, that when he doesn’t feel trapped and doesn’t fear it, tolerance can develop.  Parents have to be firm and loving, and kids can expand their tolerance.

Try the Brushing/Joint Compression program.  The one I use is the Wilbarger Protocol, developed by an amazing occupational therapist, Pat Wilbarger.  It works, but it has to be done correctly and it has to be understood.  After about 10 years, I almost stopped teaching this technique because it had turned into a game of “telephone”, in which parents would show me what a previous OT had taught them.  It looked only slightly like the protocol that Pat taught me directly.  A poorly executed protocol can actually make a child more sensitive.  It was awkward to tell parents that they had been taught incorrectly.

Get it right, and make sure that your therapist can explain the neuroscience behind it.  Have your therapist explain the gating theory of sensory modulation and the reasons that you don’t brush the abdomen or do neck compressions.  That way you know you are getting the real deal.

Is your child hypermobile?  Children with ligament laxity can have difficulty dressing too.  They just don’t have the stability even if they have the strength, to pull up their clothes and fasten garments.  Read about how your therapists can help you:  Hypermobility in Young Children: When Flexibility Isn’t Functional

Comment about any great techniques you have used successfully, so that other families learn from you!

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